What to assess when selecting potential candidates for radioiodine treatment

Assessment should include the following:

• Any feline hyperthyroid patient is potentially suitable for radioiodine treatment.
• Patients with CKD IRIS stage 3 and 4, (creatinine greater than 250 umol/l), evidence of cardiac disease (e.g. murmur, hypertension, tachycardia) or other concurrent disease will require further evaluation at ChesterGates (e.g. abdominal ultrasound and/or echocardiography) before they can be confirmed as suitable candidates.

Data needed before referring: we are happy to perform the pre-assessment at ChesterGates or for it to be carried out in your practice, but to avoid repetition, what is needed is:

• Full clinical history.
• Total T4 from a reference laboratory (not an in-house analyzer). Initial value at diagnosis is needed in addition to any further values obtained when on anti-thyroid medication.

Ideally when euthyroid on medication, but if this is not possible, shortly before referral:

• Full clinical examination recording body weight, BCS, blood pressure, retinal examination, description of the goiter.
• Routine haematology.
• Biochemistry which should include urea, creatinine, albumin, electrolytes and total Calcium.
• SDMA.
• Urinalysis: minimum USG but we like to see dipstick, sediment, UPCR (culture and sensitivity).

If you are not sure which tests you need to run before referral, please call us and we are more than happy to give advice.